systemic myxedema
Introduction
Introduction to systemic mucinous edema Generalized myxedema, also known as true myxedema, is caused by a decrease or lack of thyroxine secretion caused by thyroid dysfunction. The clinical manifestations are small sputum (cretinism), juvenile mucous edema, and adulthood. Mucinous edema. The child developed symptoms within a few weeks after birth. The performance is low basal metabolic rate, less activity, loss of appetite, slow response, and lower body temperature. basic knowledge The proportion of patients: patients with hypothyroidism, the incidence rate is about 5% -10% Susceptible people: no specific population Mode of infection: non-infectious Complications: pericardial effusion
Cause
Causes of systemic mucinous edema
Causes:
Thyroid dysfunction can be caused by abnormalities in the thyroid gland itself, pituitary, occasional or hypothalamus. Some drugs related to thyroid (radioactive iodine, antithyroid agent, lithium, p-aminosalicylic acid); cervical radiation therapy, thyroidectomy Surgery, Hashimoto's thyroiditis.
Pathogenesis:
Primary pituitary disease or injury, resulting in decreased secretion of thyroid stimulating hormone (TSH), can also lead to secondary thyroid dysfunction, such as pituitary tumors, partial pituitary resection, postpartum pituitary necrosis (Sheehan syndrome), the same hypothalamus Dysfunction, resulting in decreased secretion of thyroid hormone, and thus decreased secretion of pituitary TSH, can also cause secondary thyroid insufficiency.
Prevention
Systemic mucinous edema prevention
1. Correction of iodine deficiency: The cause of endemic cretinism is mainly iodine deficiency.
2. Reasonable nutrition: Malnutrition can cause thyroid shrinkage and hypothyroidism, which affects children's physical and mental levels.
3. Early diagnosis, early treatment.
Complication
Systemic mucinous edema complications Complications
There may be muscle relaxation, bradycardia, heart enlargement, and pericardial effusion.
Symptom
Symptoms of systemic mucinous edema Common symptoms Non-sag mucus edema The outer side of the eyebrows is sparse and the muscle tension is reduced. Obesity edema pale pale neck short reaction slow coma
1. Small illness (Kent's disease): symptoms appear within a few weeks after birth, showing low basal metabolic rate, less activity, cold, loss of appetite, slow response, lower body temperature, slower physical development, uneven Short stature, mental retardation, wide sputum, widened eyes, flattened nose bridge, thick tongue, swollen eyelids, thick and brittle hair, sallow skin, dry desquamation, non-recessed edema, short neck, abdomen Swell, limbs are short and thick, muscle tension is reduced, and crying is hoarse.
2. Juvenile mucous edema: the clinical manifestations vary with the age of onset. The incidence of young children is similar to that of minor illnesses. The older children or adolescents are mostly similar to adult mucinous edema, but with varying degrees of growth. Blocking.
3. Adult mucinous edema: reduced sweating, cold, fatigue, poor appetite, weight gain, mental retardation, low body temperature, facial expression, facial cheeks and eyelid edema, pale, anemia, ivory skin, dry, Rough, desquamation and thickening, especially in the hands, arms, thighs, non-recessed mucus edema, sparse and thin outside the eyebrows, bristles and pubic hairs falling off, nail growth slow and brittle and see vertical and horizontal stripes, teeth sparsely fragile, There may be muscle relaxation and weakness, bradycardia, heart enlargement, pericardial effusion, and severe coma.
Subclinical hypothyroidism can be confirmed by measuring the morning basal body temperature. According to the clinical manifestations, the characteristics of skin lesions and histopathological features can be diagnosed. A small amount of mucin can be detected by colloidal iron, azinc blue or toluidine blue staining. Mainly located near blood vessels and hair follicles.
Examine
Examination of systemic mucinous edema
The basal metabolic rate and protein-bound iodine and 131I absorption were both reduced.
Histopathology: no abnormal findings were found in routine skin staining. In severe cases, collagen fibers were swollen, collagen fibers were torn into individual fibers and scattered blue strips and granular proteins. Colloidal iron, azinc blue or toluidine blue staining was detectable. A small amount of mucin is present, mainly in the vicinity of blood vessels and hair follicles.
Diagnosis
Diagnosis and differentiation of systemic mucinous edema
Examination of systemic mucinous edema:
The basal metabolic rate and protein-bound iodine and 131I absorption were both reduced.
Histopathology: There was no abnormality in routine skin staining. In severe cases, collagen fibers were swollen, and collagen fibers were torn into individual fibers and scattered blue strips and granular proteins. Colloidal iron, azinc blue or toluidine blue staining can detect a small amount of mucin, mainly in the vicinity of blood vessels and hair follicles.
